Alanís-Blancas LM, Zamora-Muñoz PM, Cruz-Miranda A

Language: Spanish
References: 18
Page: 47-50
PDF size: 156.48 Kb.

ABSTRACT

In the treatment of distal femur fractures in osteoporotic elderly people with complex fracture patterns and articular compromise, results of internal fixation are not always satisfactory because they frequently require delaying weight bearing for long periods of time thus delaying the rehabilitation process. We report the case of a 70 year-old patient with supra- and intercondylar femur fracture treated with unconventional total knee prosthesis. We review the factors that decrease the success of internal fixation and the results that turn total knee arthroplasty into an appealing treatment for these patients, as they do not need long-term rest, they start rehabilitation early on and quickly return to the activity level they had prior to the injury.

REFERENCES

1. Rosen AL, Strauss E: Primary total knee arthroplasty for complex distal femur fractures in elderly patients. Clin Orthop 2004; (425): 101-5.

2. Haidukewych GJ, Springer BD, Jacofsky DJ, Berry DJ: Total knee arthroplasty for salvage of failed internal fixation or nonunion of the distal femur. J Arthroplasty 2005; 3(20): 344-9.

3. Bansi P, Testworth K: Total knee replacement for the management of periarticular knee fractures in the elderly. Curr Opin Orthop 2006; 17: 51-5.

4. Koval KJ, Meek R, Schemitsch E, Liporace F, Strauss E, Zuckerman JD: An AOA critical issue: Geriatric trauma: young ideas. J Bone Joint Surg Am 2003; 7(85): 1380-8.

5. Giannoudis PV, Schneider E: Principles of fixation of osteoporotic fractures. J Bone Joint Surg Br 2006; 88(10): 1272-8.

6. Mela G, Melis GC, Tolu S, et al: The surgical treatment of supra-intercondylar fractures of the femur. Ital J Orthop Traumatol 1989; 15: 445-55.

7. Wu CC, Shih CH: Treatment of femoral supracondylar unstable comminuted fractures. Comparisons between plating and Grosse-Kempf interlocking nailing techniques. Arch Orthop Trauma Surg 1992; 111: 232-6.

8. Nasr AM, McLeod I, Sabboubeh A, et al: Conservative or surgical management of distal femoral fractures. A retrospective study with a minimum five year follow-up. Acta Orthop Belg 2000; 66: 477-83.

9. Walz BM, Buecker PJ, Giannoudis PV, et al: Failed internal fixation about the knee. Techniques in Orthopaedics 2003; 17(4): 458-67.

10. Feroz A, Mears S: Primary arthroplasty in the elderly. Curr Opin Orthop 2008; (19): 63-7.

11. Fitzpatrck DC, Doornink J, Madey SM: Relative stability of conventional locked plating fixation in a model of the osteoporotic femoral diaphysis. Clin Biomech 2009; 24(2): 203-9.

12. Appleton P, Moran M, Houshian S, Robinson CM: Distal femoral fractures treated by hinged total knee replacement in elderly patients. J Bone joint Surg Br 2006; 88(8): 1065-70.

13. Haidukewych GJ, Berry DJ: Minimally invasive percutaneous internal fixation of supracondilar periprosthetic fractures after total knee arthroplasty. Tech in Knee Surg 2004; 2(3):122-9

14. Pearse EO, Klass B, Bendall SP, Railton GT: Stanmore total knee replacement versus internal fixation for supracondylar fractures of the distal femur in elderly patients. Injury 2005; 36: 163-8.

15. Bell KM, Johnstone AJ, Curt-Brown CM, Hughes SP: Primary knee arthroplasty for distal femoral fractures in elderly patients. J Bone Joint Surg Br 1992; 74-B: 400-2.

16. Thomas N, Pflegerl E, Erhart J, Vecsei V. Primary total knee arthroplasty for periarticular fractures. J Arthroplasty 2003; 8(18): 968-71.

17. Springer BD, Sim FH, Hanssen AD, Lewallen DG: The modular segmental kinematic rotating hinge for nonneoplastic limb salvage. Clin Orthop 2004; (421):181-7.

18. Yoshino N, Takai S, Watanabe Y: Primary total knee arthroplasty for supracondylar/condylar femoral fracture in osteoarthritic knees. J Arthroplasty 2001; 1(16): 471-5.